Researchers and community members in Milwaukee are using the Latino love of soap operas to convey health information by creating a series of fotonovelas, small graphic novels that focus on medical issues prevalent among Latinos.
The idea of creating entertaining, yet informative health literature came about after researchers from the Medical College of Wisconsin and the Centro de la Comunidad Unida, United Community Center, or UCC, a Milwaukee Latino social service agency, held focus groups on health literacy with local Latino women.
“A lot of the women said there wasn’t much information available to them, and what there was was filled with medical jargon or poorly translated,” said Melanie Hinojosa, a child-health researcher who worked for the Medical College of Wisconsin when the project began and has since taken a position at the University of Florida.
She said the Milwaukee Latino women brainstormed with researchers and decided that fotonovelas, popular in many Latin American cultures, might be an effective format because of their cultural familiarity and also their dramatic content.
“Fotonovelas have an interesting plot with a little bit of drama and spice,” explained Angelica Delgado Rendon, a researcher at the UCC who was also involved in the project. “It makes you want to read the whole thing through to the end.”
Fotonovelas have also been used in states like California and Florida to share a variety of health information to Latino populations such as the risks associated with unprotected sex and the warning signs of depression.
The Milwaukee women chose the topics of the fotonovelas, deciding that they first would focus on type 2 diabetes – a chronic disease in which the cells do not use insulin properly.
Type 2 diabetes, caused in part by obesity and physical inactivity, is on the rise in the United States, and is more prevalent among Latinos and other minorities than among Caucasians, according to the National Diabetes Information Clearinghouse. The Wisconsin researchers estimate that half of all Latino children in the United States are at risk of developing the disease during their lifetime.
Hinojosa said the pervasiveness of type 2 diabetes among Latinos is caused, in part, by lower incomes. She said families often chose to spend their limited budget on the most-calorie dense food.
“You can get more calories per dollar buying a pizza than a bag of spinach,” she said.
After holding the focus groups and successfully procuring a $450,000 grant from The Healthier Wisconsin Partnership, the researchers handed out digital cameras to the local women and asked them to take photos while they were shopping for food and preparing meals. The women also took nutrition classes and later helped make story boards, plotting out the characters and action of the fotonovela.
It was important to involve members of the local Latino community in every step of the project because they know the fotonovela’s intended audience – the way they talk, dress and act — better than the researchers, said Hinojosa.
“If you don’t ask people from the local population and get their voice on the project, it won’t be done as well,” she said.
The end result of the collaboration was a 15-page booklet, published in English and Spanish, that begins with one Latino woman telling another that she is worried because a doctor has told her that her son is at risk for diabetes because of his diet and lack of exercise. That news gets the other mother thinking about her own children and motivates her to make changes in her family’s routine.
She goes food shopping with her children and they take the time to read nutrition labels and chose low-fat foods such as chicken instead of beef and vegetable oil instead of lard. They also bought more fruits and vegetables.
Graciela Hernandez, a local Latino mother of four whose family served as models for the fotonovela, said it made a big impact on her. She said she uses more vegetables when she cooks now and checks nutrition labels for not just calories but for fat and sodium.
She said her kids are also more health conscious.
“My son used to drink a lot of soda but now he drinks just water, or Gatorade with water added to it,” she said. “And my daughter is exercising more, playing volleyball and soccer. It's really helped her self confidence."
Delgado said preliminary research, conducted on 50 random members of the Latino community, showed that people who read the booklet had better knowledge of diabetes prevention.
“They all really loved it,” she said. “They found it really touching and said they could relate to the people and the situations.”
Nancy Averett is a freelance writer based in Cincinnati, Ohio.